Scottish Government

Smoking in Public Places
A Consultation on Reducing Exposure to Second Hand Smoke
Report of Regional and Area Events

REPORT FROM THE SECOND SCOTTISH EXECUTIVE REGIONAL CONSULTATION EVENT - GLASGOW ROYAL CONCERT HALL

Tuesday 20 July

This was the second in the series of public consultation events on smoking in public places. The event was well attended, with 237 attendees.

Debbie Wilkie, Director of the Scottish Civic Forum chaired the meeting, which consisted of brief panel presentations, followed by a questions and answer session and then group discussions. Panel presentations were made by:

• Tom McCabe, MSP, Deputy Minister for Health and Community Care

• Paul Waterston, Scottish Licensed Trade Association (SLTA)

• Maureen Moore, ASH Scotland

• Laurence Gruer, NHS Health Scotland

In addition, Jim Devine, UNISON was a panel member.

Plenary

There was a lively discussion following the presentations from the panel.

Representatives from the licensed trade questioned the validity of the statistical information being quoted and cited alternative research which was claimed to cast doubt on the case for a ban. Panel members contended that the evidence they quoted was up-to-date and relevant.

A number of publicans argued that extraction units were the answer to the problem but panellists responded that although these make the atmosphere more pleasant they do not remove carcinogens from the air so do not deal with the problem.

Others were concerned that if people could not smoke in pubs they would stay at home, exposing children to more smoking. Panellists supporting a ban did not believe this would happen.

It was pointed out that there are other contributors to carcinogens in the atmosphere e.g car fumes - so why pick on smoking. It was pointed out that legislation already exists relating to exhaust emissions.

Some people felt that there was an issue about freedom of choice and that on one hand people should not be forced not to smoke and on the other people who objected to smoking could go somewhere that people don't smoke - no-one forces anyone to go into a pub. Health panellists argued that most smokers would like to stop smoking and a ban could help them.

It was put forward by licensed trade reps that the existing voluntary code was working well and there should be renewed encouragement to adopt it but to add the compulsory elements put forward by the Voluntary Charter Signatory Group. This was refuted by the Minister who said that whilst progress had been made, 7 out of 10 pubs still allowed smoking throughout.

A number of people raised the issue about the impact of smoking on staff.

Some people from the floor supported a ban.

After the panel session, all those in attendance were invited to join one of four discussion groups, which ran simultaneously. The group discussions were aimed at providing everyone with an opportunity to raise their views on the proposals and discuss these with others. Each group was facilitated by a Scottish Civic Forum facilitator who assured participants that all views would be fed into the Scottish Executive to inform the consultation. The group discussion sessions followed the sequence of questions posed in the consultation document.

The group totalled 20 participants, being a god mix of licensed trade, health workers and individuals with no expressed affiliation to any interest groups.

Ground rules were agreed for conducting the discussion and a five-point structure for guiding the discussion (as set out in the response form "Smoking in Public Places").

Addressing the first of these questions regarding the need for any further action there was complete agreement that there was a need for additional action over and above the voluntary approach thus far adopted.

On the suggestion of one participant, and in an attempt to move the discussion forward, a show of hands was sought on whether there should be legislation. A 100% agreement on the need for legislation was expressed. However, this was not legislation for a smoking ban but for a reasoned approach with careful consideration as to what form the legislation should take. Having established this total agreement the following represents individual concerns/observations/suggestions:

Any legislation needed to take on board individual's civil/human rights.

Whilst legislation was supported it was not felt that enforcement of it would necessarily result in a culture change vis-à-vis smoking habits and the take up of smoking by young people. Regardless of legislation there was strong support for additional educational campaigns to minimise the take-up rates of young people.

There was much concern with regard to what was perceived as some very entrenched views that were expressed by panel members, and that these views often contradicted each other. It was suggested that what is required is a far better setting out of the "facts" relating to the whole issue so as informed decisions can be made.

Instances of the above are a) the benefits/effectiveness of extractor systems, b) clearer supporting evidence with regard to passive smoking. Perhaps time, money and effort should be spent on developing better extraction systems.

Huge cynicism expressed with regard to the agenda of some of the parties involved, with a feeling that some research is carried out by particular interested bodies, and that the anti-smoking lobby are so immovable that they do, in fact, alienate some people who would see themselves as supporters of the cause.

Status quo not acceptable - need to move forward.

Concerns expressed about putting too much emphasis on the "successes" of the approaches adopted in Ireland and New York - not convinced that the "facts" quoted are legitimate - but regardless of this we should be making the case for Scotland based on meaningful information and facts as already mentioned above.

Some concern expressed over how enforcement would be achieved and who would be responsible for this enforcement.

Legislation would provide a level playing field that any voluntary code does not.

Huge disquiet at the message received from the panel that the licensed trade did not care for staff. Again this was perceived as an accepted fact that supported the need foe a smoking ban.

Real worries as to the effect a ban would have within the licensed trade with projected income loss of up to 20% - do not accept the Irish/New York experience as a true reflection of reality.

"Using the licensed trade to reduce smoking is ridiculous".

Particular concerns within the Glasgow scene expressed in relation to restrictions placed on landlords regarding prices when supermarkets are allowed to use alcohol as huge loss-leaders. If there is genuine concern by government regarding the health of the Scottish people then there are other issues that need to be looked at.

Current approach seen as "cherry-picking" on smoking but there are accepted links between smoking-drinking-gambling. Should there not be a more joined up approach? What will be next? Is this the first step towards to banning other things e.g. drinking in public places.

Problem seen with a smoking ban that this will push the smokers out on to the streets, leading to further public disorder.

Large organisations are seen to be getting support and subsidies to help their smoking policies(cessation clinics, patches etc.)so should there not be some consideration for supporting businesses that lose income as a result of legislation?

The way forward seen as providing choice so people can make their own decisions on where they wish to socialise.

In conclusion there was total agreement that what is required is a meaningful process of collaboration from this point on. The following is put forward as a proposed process:

Total clarity needed as to the definition of "enclosed public space". Does this, for example, include private clubs?

More information required with the relevant facts produced to inform rather than shock.

More education required to assist the reduction of smoking generally.

To arrive at legislation that will work, and be supported by affected parties, there needs to be better dialogue between them, meaningful exchange of views/information and the removal of some of the entrenched, and often emotive, views as seen at today's meeting.

Proper review in 3-5 years to determine what has worked and what, perhaps, needs to be revisited.

In summary, this was a very positive discussion with total agreement that legislation is required, but that such legislation needs to provide choice.

At the end of a discussion in which people felt very strongly but were prepared to listen to each other the following points were agreed:

• That Environmental Tobacco Smoke (ETS) is harmful.

• That legislation is required.

• That the current voluntary code for licensed traders is inadequate.

The following points were also raised in the discussion - and have been transcribed from the flip charts in the order in which they were spoken:

View in voluntary/community sector (not aired in debate with panel) - more a health and safety issue than 'rights versus choice'. Advise Executive to 'take bull by the horns'

Not necessary to attack personalities when discussing the issue.

Possible to exercise choice by being a non-smoker in the service industry.

Smokers do not need scientists to choose for them. Non-smoking environments can lead to more children in bars but what about those who wish to drink and socialise in a child free environment?

Looking closer at 'choice' - people currently still affected by smoke in the work-place have no choice. Seems odd that less harmful drugs are banned/controlled by law, but smoking is not.

Statistics coming from Ireland do demonstrate a drop in business in the affected sectors. Jobs in Scotland would be at risk which will increase poverty and affect already poor areas disproportionately. There are good practices (in relation to the voluntary code) in place and these could be extended.

The press evidence of fall-off in business could be questioned in relation to New York. Publicans' tax returns indicate an overall increase in trade and employment.

From a medical perspective, doctors appreciate the problems of the licensing trade but the fact remains that the voluntary code is not working despite good practice in some areas. The '3 ft from the bar' suggestion is 'a nonsense'. And even with the best technology filtration does not work.

Statistics coming from places that already have a ban in place are conflicting and confusing. If this really is fundamentally a health and safety issue the Executive should be considering an outright ban on the sale of tobacco.

Should remember that those who are currently trying to improve the environment i.e. publicans etc. also work in it. The real answer is better education about the effects of smoking.

The licensing trade would welcome 'a moderate thought out response from the Executive. Not a moral knee jerk'

Isn't it better to lose a job than to lose health and possibly life itself?

The onus is on the lobby who do not want further strict legislation to produce real evidence of jobs lost when such legislation is put in place and real evidence that improved ventilation can be effective in every circumstance (who has considered the effect of smoke on babies in bars but not near the bar/counter for example?). The Scottish Consumer Council reports are useful.

A retired footballer, now licensing trade manager, commented that those keen on sport are very aware of dangers to health but that many traders are subject to decisions made by large multi-national companies. It does seem that trade in New York had fallen and then picked up but that trade in Ireland was still depressed by the new legislation. It has been estimated that as many as 200,000 jobs could be lost in Scotland if you include jobs associated with as well as directly involved in the licensing trade.

Should remember the specific problems of the large number of asthma sufferers in relation to tobacco smoke. What about their freedom to chose a completely smoke free environment? Also the best education for children is simply not to see so many people smoking. It will be slow process to really effect change but the Government must take a clear stand now.

The rights versus choice argument comes down to the fact that none of us have a 'right' to activities that harm other people.

A cancer specialist present commented that there is no safe level of exposure to tobacco smoke and further that we are in the same situation in relation to smoke as we were in relation to asbestos 15 years ago. There are at least 49 chemicals in smoke that are carcinogens and no filtration system or distancing measures can completely excludes all of these. As with asbestos any exposure at all to these chemicals could be harmful. The absence of an actual smell of smoke is not a reliable indicator of the absence of these chemicals. It is not physically possible to 'seal non-smokers away' when they are close to a smoking environment. Good research on this issue has been done in Australia.

If this is true the government should not hesitate to impose a complete ban on the sale of tobacco - just as a complete ban on the use or handling of asbestos was imposed when the risks were understood.

Again if this is true this debate will be brought to an end when employers not protecting their staff from smoke are sued.

Must remember that the significant difference between asbestos and tobacco smoke is that the latter is addictive.

Those employers who do not comply with the law 'should get hammered'.

There was a short discussion at the end about the matter of possible exemptions to any new law but no agreement as to whether certain places should be exempt.

This workshop contained about 26 people form a wide range of backgrounds. Some were from licensed trade, some from health related professions, councils, etc, and some were there as individuals with an interest.

Having listened to the main debate the following comments were made:-

Observers felt that the panel was not balanced - only one person from the licensed trade yet a number from the anti-smoking lobby.

Some people were upset at the performance of the ASH representative - they felt that she had not been polite and had been over-forceful in presenting her case - people felt that the tone of the ASH presentation was wrong - less preaching tone would have been better appreciated.

Addressing question 1 on the response form, people unanimously agreed that more needed to be done to cut down smoking in public places. No one argued that enough had already been done.

People recognised that it would be extremely hard for the licensed trade to pursue measures but felt that it was essential and unavoidable.

There was some discussion around the proposals that had been put forward by the licensed trade at the main meeting. People felt that the 'no smoking within 3 feet of the bar' proposal was unworkable and unmanageable. They also stated that it would not protect bar staff who would still have to go beyond this zone to collect glasses, etc.

There was a strong statement that workers have the right to work in a safe environment and that the licensed trade's proposals would not secure this. People agreed that legislation was required to secure this beyond doubt.

A minority of those present argued that there needed to be freedom of choice for smokers also and that this would be taken away. They felt that smokers were being targeted by this legislation and little was being done to assist them or to understand the difficulties that they would encounter if any major change is introduced. They believed that bars and restaurants should always contain a smoking area so that they did not have to go outside and that their needs were catered for. They suggested 'beer gardens' wherever possible but recognised that not every premises could do this.

Others strongly argued that smokers would have to make sacrifices in order to pursue a greater public good. The interests of the licensed trade would have to take second place. Publicans have had to accept other legislation and controls so why not accept greater control in smoking practices? People pointed out that other businesses such as cinemas, etc, have survived a ban on smoking and therefore the licensed trade should be able to survive a similar change.

If any legislation is introduced then people stressed that it needed to be the same for all affected. It should not be left to the discretion of individual local authorities - it should be one law for all! There should be no acceptance of geographic differences.

Some argument was made for a gradual introduction of new legislation. Change should not be too rapid and the trade should be allowed time to make adjustments and to plan for the changes.

Some smokers stated that they would be likely to give up going to pubs and to drink more at home. They said that there was a culture of smoking and drinking together which they were part of and that if the could not smoke in pubs then they would go somewhere else to drink - probably their own home where they might affect members of their own family - including their own children.

Some people reminded the meeting that this was not just about pubs but about all public places. This led people to comment that it was difficult to accept that there might be exceptions to a ban - e.g. prisons and old folks homes.

The following basic question was asked:-

If this legislation is being introduced to protect the health of workers then how can you abandon workers who work in a prison or residential home? Surely their health is just as important as that of the licensed trade? There is a basic inconsistency here that people struggled to accept.

On balance the meeting could not justify exceptions to any ban on smoking. One person advised that his job required him to visit people in their own homes and he felt that his health would not be protected by this legislation.

Some people argued that there is a great opportunity for politicians in Scotland to lead these changes and to promote them internationally to other countries. People spoke highly of the efforts made in Ireland and did not believe some of the negative stories that were coming from Ireland and argued that the true economic impact of the changes could not yet be properly assessed. Only time will tell!

Scotland should lead on issues of moral responsibility and good citizenship and thus should promote a full ban on smoking in public places - anything less would be to fail in this international role.

Smokers said that smoking is an addiction and that they will need significant help to move towards less smoking. They made a plea for help to be given to licensed businesses - that the government should introduce grants, incentives, or rate relief, to those businesses most affected, to help them through a difficult period.

Many people believed that this proposed legislation was stimulated by the government fearing litigation against them and companies from damaged workers. They wanted a wider publication of all legal cases that might be brought by workers. People think that there will be a number of test cases and they want to see them widely publicised so that they can see the seriousness that the courts give to these cases and so that we can all learn from the misfortune of a few.

Some people argued that heavy policing and fines were not the way forward. Many premises have been able to ban smoking by simply appealing to the good citizenship of their customers. It may take time but this kind of voluntary compliance and self-policing is a much preferable method of securing behavioural change.

While these changes are made, there is a major role for government in properly resourcing wider education and awareness programmes. They also need to increase the help and counselling services for smokers as part of the overall package.

The group numbered at least twenty five, and were a good mix of health professionals, licensed trade workers and others.

We started with Q1, which asked if further action was needed to reduce people's exposure to second-hand smoke. Nobody made any comment. This could be explained partly by it being the first question in a group discussion, which is always hard to respond to, but no subsequent comments were made to suggest anyone thought that this was not an issue which had to be addressed.

The feeling was that people had come to the event to put forward their views on Q2 - should we legislate against smoking in public places? This brought forward the main conversation in the workshop. Points were made as follows:

The suggestion of banning smoking in public places is hypocritical. If the government really mean it, they would be banning smoking full stop.

The government wouldn't ban smoking outright because they would lose all that revenue they get from taxing cigarettes.

What's wrong with the existing Health & Safety Act? Can't they just ban smoking under that? (it was clarified that this was not the case, and that in any case that was an issue reserved to Westminster).

This is an issue with a lot of grey areas.

There's nothing grey about the health problems caused by secondary smoking - it's as black and white as you can get.

Everyone still has the basic choice of whether or not to enter any licensed premises or not.

People should have the choice between pubs that allow smoke and those that don't.

Yes, but you don't have that choice in other public places, like cinemas, aeroplanes etc.

What about choice for employees in these places? What choice do they have about whether or not they inhale secondary smoke? It can be very difficult for staff to challenge the smoking habits of their colleagues or the rules on smoking in their workplace. Legislation would help them.

In trying to protect these people working in pubs and clubs, you will be seeing them out of a job in many cases. Redundancies are inevitable in the licensed trade as a result of any legislation. People will stop coming to pubs.

Although two-thirds of Scots don't smoke, a much higher percentage of pub-goers do smoke.

Nightclubs also stand to lose a lot of revenue/custom. People will just go home where they can smoke rather than go on to a club where they can't.

It is very important that the culture be changed in Scotland away from accepting smoke-filled places. Even the 'old men's' pubs would have to be tackled.

The smoking culture goes beyond pubs, as do the proposals in this consultation.

People should be given the choice.

The idea of choice is not applied to other areas where we stand to do ourselves damage, sop why in this area? You don't get to choose whether or not you wear a seatbelt, or whether or not you drive too fast.

But a ban on smoking would drive it underground.

This is a health issue, and it has been shown in other countries that a ban on smoking does reduce the amount that people smoke, and the amount of people who smoke.

Poverty is the real issue here.

Is this the beginning of more controls over our lives? Will they tackle our obesity levels by banning restaurants from providing all-you-can-eat buffets?

Smoking is a different issue. The people at the tables next to you at a buffet don't get affected by your over eating.

There is a lack of public knowledge here about the dangers of secondary smoke. People don't seem to know about how toxins are transmitted from person to person.

Cinemas banned smoking years ago, yet they haven't all closed down through lack of business (a debate on the health of the cinema industry ensued, to no conclusion).

The point is that people get used to change. Would the cinema owners not have been having this same debate at the time they had to change?

Many factories would have been decrying the end of their business when government said they couldn't use children any more, or when asbestos had to be removed from everywhere. A time will come when we look back on this debate and wonder how there ever was a time when we actually allowed people to smoke in public places.

It had been mentioned that the Pizza Hut national restaurant chain had banned smoking throughout all of its outlets. It would be interesting to know how they are doing financially since the ban.

Yes, but pubs are different. This proposed legislation will interfere with the fabric of Scotland's social life. Scotland socialises in the pub, and it will be disastrous to tamper with that.

Can't see why the licensed trade should be a special case, when everyone else is looking to get rid of smoke and it's effects on our health.

California installed a ban on smoking 12 years ago, and have reported a steady rise in profits since.

Yes, but California has a very different climate to Scotland. The reports from Ireland that the smoking ban has not affected profits may well change once they face their first winter. People won't be so happy to go outside for a smoke when the weather turns.

There are also potential problems ahead with gangs of people standing outside pubs for a smoke. Could lead to violence, litter, noise pollution, and will put passers-by off from entering a pub. We need to hear some thoughts from the police about what they think.

Exemptions to Legislation

It has been suggested that residential care homes be made exempt from any legislation because they are residence to people. However, they also have staff, who would continue to face the dangers of secondary smoke

Alternatives

Legislation could be developed to help the (licensed trade) industry improve the environments they provide.

Ventilation had been discussed earlier at the event, in that pubs and clubs had spent thousands of pounds installing ventilation systems under a previous scheme, which they were now being told were useless in the fight to remove toxins from the air. Conflicting evidence existed which suggested that ventilation systems were doing a good job of removing smoke from venues. Some people reported feeling very confused about who to believe.

Instead of setting the licensed trade up against the government, we should be trying to get all interested parties to work together here.

There should be restrictions on smoking only where it is a fire hazard.

What about putting money into the development of ventilation technology. It's hard to believe that we can't manage to create a ventilation system which would completely remove all dangerous cigarette toxins out of a room.

Would like to know what is behind the Scottish Licensed Trade Association suggestion that the government ban smoking within 3 feet of the bar in all venues. Is the distance of 3 feet a scientific one, or is it arbitrary?

We need evidence/statistics that we can all agree on, so we can stop this bun-fight and start to advance the debate properly (there had been a lot of arguing over who's statistics were valid all day, between the SLTA and the health professionals).

There should be legislation which states what percentage of floor space in all venues should be smoke-free.

A ban on smoking around where food was prepared or served would be supported.

Any legislation at all would cause all sorts of problems for the smaller, rural pubs which are often just one small room.

Yes, but what about the extra custom they might attract? Many people don't go into pubs because of the smoky atmosphere. Especially the small ones, where you can't escape smoke.

SLTA are pushing for government to adopt a policy on smoking, but what we need is a policy on non-smoking

SLTA are not considering the welfare of staff in their proposals

We can't delay legislation any longer

The government should be investing more in nicotine replacement therapy

A ban on smoking in public places will in fact increase the risks in the home. If people are staying in to smoke, it is children who will be subjected to more secondary smoke

All this may be redundant. As mentioned earlier in the event, trades union have already started to prosecute employers who have caused ill-health to employees by allowing smoke in the workplace. Once a few of these cases have been won, pub landlords will realise that the only way to avoid prosecution is to ban smoking in the venue. Legislation won't be needed when the threat of legal action arrives

The conversation was passionate, and there is no doubt that licensed trade workers were genuinely concerned about their future livelihoods. Equally passionate were the health professionals, who see smoking as a huge health problem. The make up of the group inevitably led to polarised views, with one side wanting no legislation at all, and the other wanting nothing less than as much as possible. However, it was clear that the battle of the statistics was not helping the debate, with both sides dismissing the others' research. The debate about choice was very interesting, especially about where one persons freedoms ended, and another's began.

Introduction: began with basic rules: respect for others; all points of view valid; no consensus required; those speaking should be listened to.

Role of facilitator: impartial; reporting back to the SE; would ensure a fair spread of time for all people who wished to speak. Asked that comments were made through facilitator.

Started with question 1

Complete agreement that some action was required. Show of hands indicated a split between voluntary action (or what later transpired to be alternative legislation) and legislation to prevent smoking in enclosed public places. Members of Licensed Trade were in the minority.

Agreed that issues would be time restricted to try and cover the different sides. First 15/20 minutes were spent on views regarding voluntary action:

Use the model of noise abatement to reduce levels of smoke in public houses. A member of the public who was concerned about levels of smoke could inform Environmental Health who could investigate and take [enforceable] action.

The current voluntary charter does not involve Environmental Health and that was seen as an omission.

Current voluntary targets have been met. There should be recognition of the positive contribution made by pubs to reduce smoke pollution.

Move ahead with the development of new targets as part of a staged process.

Point was made that bar staff move beyond the confines of the bar and therefore the 3ft "rule" was ineffective.

A suggestion was made that only smokers should be employed by pubs and that might therefore alleviate the potential for legal action by non-smokers.

Pubs need to consider employees and customers, as both needed protection from smoke pollution.

Don't necessarily notice carcinogenic properties therefore ventilation systems are ineffective. The criteria for ventilation is too low. Need legislation?

The question hinges on whether a voluntary code would work. It should apply to all premises as presently not all are at the same standard.

Paul Waterston (SLTA) has the right idea. His proposals are progressive.

Enforcement: who will be responsible?

Legislation - there is no safe level of tobacco smoke, without legislation there is no level playing field.

Legislation should apply across the UK.

The financial implications of a "ban" have not been fully recognised.

This is not a financial matter - it's a health matter.

Legislation might help smokers to limit their smoking.

12b is provided through tobacco companies, only 2b spent on healthcare for smoke-related illness.

Government needs to make up its mind if it wants to ban smoking or take the money.

Where's the research into implications for the hospitality industry?

We need a culture change towards healthier lifestyles. This isn't an attack on pubs.

Licensees want to work with the Government.

There has been a gradual change through buses, cinemas etc. Pubs are the next part in that change process

Its not just a pub issue this is relevant to other work environments.

There's a lot of uncertainty about the impact. Would a smoke-free pub attract more/new customers? Discussions were missing that potential. How can we gather facts?

Can't start this with the notion that it will result in more people giving up smoking.

Licensees do want to change. Should consider an alternative legislative route.

Can't make any improvements without working together. Need to move away from entrenched positions.

Last 5 minutes were spent agreeing a summary for plenary:

Agreement that statutory action is required. Different views on the form it should take.

Want to work together and need to do so.

Recognise the concerns of the Licensed Trade and Health workers.

More information is needed on likely implications and impact.

Need UK-wide legislation

More information on enforcement required.